This diagnostic injection into the area that surrounds is done to define the pain experienced by the patient, more precisely. Therapeutic steroid and local anesthetics are used to decrease pain and inflammation. Pain relief from the procedure can be minimal to long-term. It varies from patient to patient and it depends on the specific symptoms. Symptoms must be present for this procedure to be effective. Patients with radicular symptoms (pain into an arm or leg), which can be localized to a specific nerve root distribution, may benefit from a diagnostic and therapeutic selective nerve root injection.
The patient remains awake throughout the test. Using x-ray fluoroscopy Dr. Varley uses a thin needle to place anesthetic and steroid into the nerve sheath. The patient may experience some discomfort at this time. The physician checks the needle position by means of a fluoroscope (x-ray) connected to a monitor. Contrast material, which outlines the nerve root, is placed into the nerve sheath to document the needle position and x-rays are taken. A small mixture containing a steroid and an anesthetic is injected. The immediate response to the injection is reported to help the physician with his management and treatment planning. This procedure may be repeated at 2-week intervals, up to 3 times. The goal, usually, is to avoid surgery. During the injection, the patient may feel pressure or pain. The doctor will want to know how this discomfort compares to the patient's usual pain symptoms.
About 5% of patients will have side effects of steroid medications. These side effects include: facial flushing, insomnia, and occasional low-grade fever. Usually the symptoms disappear within a couple of days.